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pS Instruments (2): CAHPS Consumer Assessment of Health Plans Survey, developed by the Agency for Healthcare Research and Quality (AHRQ) in the U.S. A CAHPS-questionnaire captures the experiences of patients with received care and experiences of customers with a health plan.

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pS Construction (2): proces Extra questions were added in the following CAHPS: Commercial CAHPS-NL: questions about language spoken in order to see differences in non-Dutch origin and Dutch origin; Diabetics CAHPS-NL: QUOTE*-questions about specific diabetic-care (formulated in CAHPS structure). * QUality Of care Through the patients’ Eyes. The Quote-Diabetes is developed by Nivel, 2000.

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pS Validation: Key findings Commercial CAHPS-NL Compares health insurance companies on Getting needed care Getting care quickly Courteous, respectful and helpful office staff How well doctors & nurses communicate Health plans customer service, information and paperwork Global ratings (nurses, doctors, hospital, health plan) Patient/Consumer demographics The translated questionnaire is found to be a useful instrument in the context of the Dutch healthcare system; A few questions should be adjusted to improve the questionnaire; Overall the new instrument was found to be valid and reliable.

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pS Validation: Key findings Hospital CAHPS-NL Seven factors relating to patient hospital experience were constructed: communication with doctor communication with nurses discharge information communication about medication pain control physical environment nursing services Communication with nurses had the strongest relationship with the global ratings for nurses and hospital and likelihood of recommending the hospital; Differences between the two hospitals can be pointed out as differences between quality Overall the new instrument was found to be valid and reliable; The findings mirrored the results in the US and surveys in Dutch hospitals.

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pS Experience hospital A and B (ill and healthy)

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pS Experience (hospital A and B)

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pS Population (hospital A and B)

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pS New Medication and discharge experiences Both hospitals have low outcome on new medication Purpose and name of the medicine Co-medication Side-effects Allergic reactions Both hospitals have low outcome on discharge information Information how to behave Information about taking notice

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pS Validation: Key findings Diabetes CAHPS-NL For a few aspects the findings mirrored other studies. There are limited studies available to compare; Ratings of patients have a relationship with the period in witch care was received (check of HbA1c, Cholesterol, blood pressure, feet); A few questions should be adjusted; Overall the new instrument was found to be a valid and reliable basis for further development.

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pS

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pS

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pS

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pS Show respectListening carefullyExplain thingsHave enough time Total

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pS parameterprocesUitkomstenPunten HbA1c (Long term suger) 93% of the patients had their HbA1c measured in the last 12 months 55% < 8% ≤ 21% ≥ 9,5% 5 10 Lipid profile85% of the patients had their lipid profile measured in the last 12 months 63% heeft LDL ≤ 130 mg/dl 20 Risc profileOf 90% of the patients the risk profile is known based on blood pressure, Hba1c and lipid profile Improvement of 10% 40

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pS parameterprocesuitkomstbonus Patient experience90% is informed about HbA1c, blood pressure and life style 80% knows their own level of HbA1c, blood pressure and reproduces life style advise 20 afstemming (interaction between professionals) 80% gets uniform information from the different health providers of goals to achieve 20